Do I Have Cancer?: Signs, Symptoms, Diagnoses, and Treatments of Fifty Common Cancers

By Dr. N. Parajuli

More people die of cancer than AIDS, tuberculosis, and malaria combinedand its expected that annual cancer cases will rise from fourteen million in 2012 to twenty-two million within the next two decades.

Dr. N. Parajuli, a medical doctor and family practitioner, shares the knowledge hes gleaned over twenty years of researching cancer and the needs of cancer patients in this guide to recognizing symptoms, understanding the treatment process, and living as normal a life as possible.

Whether its cancer of the liver, kidney, neck, eye, brain, bladder, skin or some other area, youll get tips on detecting cancer early and clear explanations of what to expect once youre diagnosed. The book includes sections on cancer during pregnancy, cancer and sexuality, psychological problems among cancer patients, pain management, and new developments in cancer treatments.

Hundreds of vocabulary words related to cancer and explanations of the roles that different types of medical and health professionals may play in diagnosis and treatment make this an important resource not just for patients but for anyone supporting a loved one with the disease.

• Language: English
• Publisher: Balboa Press AU
• Release date: Jul 17, 2015
• ISBN: 9781452529899

Dr. N. Parajuli

Dr. N. Parajuli is a medical practitioner and family doctor and has researched the needs of cancer patients for twenty years. He is involved in all aspects of cancer management, including the diagnosis, treatment, follow-up, and counseling of cancer patients.

Book preview

Section One

Cancer Overview

Chapter 1

Learning the Cancer Language

There are over one hundred different types of cancer, and each type can have different symptoms, diagnostic tests, and treatment options. As a result, many terms and phrases are used to describe the types of cancer, symptoms and diagnoses of cancer, and treatment methods. It is often confusing and frustrating for readers if complex medical jargon and terminology are used when discussing cancer. This can make it difficult for readers to understand the context of the topic or take action if required after reading the book. Information can be misinterpreted or not fully comprehended.

Keeping this in mind, I have made every effort to explain all the phrases and terms used in this book at the outset. Thus the first part of this chapter describes the terms and phrases used in relation to cancer, the second part discusses body parts affected by cancer, and the third part describes the health and medical personnel who are directly or indirectly involved in the diagnosis and treatment of cancer. Most terms and phrases are also described separately in the individual chapters that follow.

Cancer Terminology¹

A

ablation: The removal or destruction of a body part or tissue.

abnormal: Not normal.

acupuncture: A type of complementary treatment in which many thin needles are inserted at specific points in the body to control pain.

adenocarcinoma: Cancer that begins in the lining of internal organs or the skin.

adenoma: A non-cancerous tumour that begins in the glands.

adenopathy: Swollen lymph glands.

adjunct or adjunctive therapy: Another treatment used together with primary treatment. For example, radiotherapy is sometimes given after surgery to treat cancer as adjunctive treatment.

alpha-fetoprotein (AFP): A protein normally produced by a foetus and usually not detected in the blood of healthy adult men and women. An elevated level of AFP may suggest a primary liver cancer or germ-cell tumour.

alternative medicine: Medical practices used instead of conventional (standard) treatments. Examples of alternative medicine include herbal medicines and high doses of vitamins.

amputation: Surgery that removes a part of a limb or entire limb or other structure, such as amputation of the leg or penis.

analgesic: A drug that reduces pain. Analgesia means pain relief. Examples of analgesics are paracetamol and ibuprofen.

anatomy: The study of part of the body, such as the anatomy of the liver.

androgen: A male hormone. Anti-androgens are substances that prevent cells from creating androgens. Some anti-androgens are used in the treatment of prostate cancer, such as cyproterone and flutamide.

anaemia: A low level of red blood cells in the body.

anaesthesia: A loss of feeling or awareness that is commonly caused by drugs. It can be local, regional, or general anaesthesia. The drug that creates anaesthesia is an anaesthetic.

angiogram: An X-ray of blood vessels in which the person is given an injection of dye that outlines the blood vessels on the X-ray.

anorexia: An abnormal loss of appetite for food.

antidepressants: Drugs used to treat depression.

antiemetic: A drug that prevents or reduces nausea and vomiting, such as metoclopramide.

anti-inflammatory drug: A drug that reduces inflammation or swelling, such as ibuprofen or naproxen.

antiretroviral therapy: Drugs used in the treatment of viruses, such as human immunodeficiency virus (HIV).

anxiety: Feelings of fear, dread, or uneasiness that may occur as a reaction to stress. Anxiety is very common after a diagnosis of cancer.

anxiolytic drug or agent: A drug used to treat anxiety, such as benzodiazepines.

aromatase inhibitor: A drug that prevents the formation of a female hormone called estradiol. Aromatase inhibitors, such as anastrozole and letrozole, are used as a type of hormone therapy for postmenopausal women who have hormone-dependent breast cancer.

aromatherapy: A type of complementary therapy that uses plant oils that exude a strong smell or aroma to treat certain conditions. An aromatherapist is a person who practises aromatherapy.

asbestos: A group of minerals that are found in the form of tiny fibres. It is used as insulation against heat and fire in buildings. When breathed into the lungs, asbestos dust can lead to lung cancer and mesothelioma.

asthenia: A feeling of weakness or lack of energy. This is common in late-stage cancer.

astrocyte: A type of cell in the brain or spinal cord. An astrocytoma is a tumour that begins in astrocytes.

asymmetry: Something that cannot be cut into two equal halves.

asymptomatic: Having no signs or symptoms of disease. Most cancers are asymptomatic in the early stages.

autologous: Taken from an individual’s own tissues or cells.

axilla: The armpit or underarm; axillary lymph node.

axillary lymph node dissection: The removal of lymph nodes in the axilla. This may be done in the treatment of breast cancer.

B

B-cell: A type of white blood cell that creates antibodies and fights infection in the body.

B-cell lymphoma: A type of cancer that forms in B-cells.

barium enema: A procedure in which barium is injected through the anus into the rectum and colon. Barium makes pictures clearer on X-rays.

barium swallow: A procedure where a patient drinks a liquid that contains barium and then has pictures taken of the oesophagus, stomach, and duodenum. Barium makes pictures clearer on X-rays.

Barrett oesophagus: A condition in which the cells lining the lower part of the oesophagus have changed or been replaced by abnormal cells that could lead to oesophageal cancer. The regurgitation of the contents of the stomach into the oesophagus over time can lead to Barrett oesophagus.

basal cells: Small, round cells found in the lower part of the epidermis. The cancer that begins in the basal cells is called basal cell cancer or basal cell carcinoma.

BCG: BCG stands for bacillus calmette-guérin. This is a vaccine given to prevent tuberculosis. BCG also stimulates the immune system to fight cancer. It is used as immunotherapy in the treatment of bladder cancer.

Bence Jones protein: A type of protein found in the urine of most people diagnosed with multiple myeloma.

benign: Not cancerous; synonymous with non-malignant. A malignant tumour is a cancerous growth. For example, fibroadenoma is a benign tumour of the breast, while adenocarcinoma is a malignant tumour of the breast.

benign prostatic hyperplasia: A non-cancerous condition of the prostate, in which there is overgrowth of prostate tissue.

benzene: A chemical widely used in chemical industries. Exposure to benzene may increase the risk of developing leukaemia.

beta-human chorionic gonadotropin (β-HCG): A hormone normally found in the blood and urine during pregnancy that can also be produced by some tumour cells. A high level of β-HCG may be a sign of cancer of the testis, ovary, liver, stomach, pancreas, or lung.

bilateral: Affecting both sides, such as bilateral cancer of the ovaries.

bile: A substance produced by the liver and stored in the gall bladder that helps digest fat.

bile duct: A tube that carries bile. Bile duct cancer begins in the bile duct.

biliary system: This includes the liver, gallbladder, and bile ducts.

bilirubin: A part of bile. High levels of bilirubin in the body cause jaundice.

biological therapy: A type of treatment that uses substances made from living organisms or their products to boost or restore the ability of the immune system to fight cancer. Examples of biological agents include vaccines, interleukins, and monoclonal antibodies.

biopsy: The removal of cells or tissues from the cancer or suspected cancer area for examination by a pathologist. This is the surest way to diagnose cancer.

bladder: The organ that stores urine.

blood vessels: Tubes through which blood circulates in the body. These include arteries, veins, and capillaries.

BMI: Body mass index. This is used to classify body weights into the categories of healthy, overweight, obese, or underweight.

bone marrow: The inner spongy part of the bone that produces red blood cells, white blood cells, and platelets.

bone marrow ablation: A procedure that destroys bone marrow through the use of radiation or high doses of anticancer drugs. It is undertaken before a bone marrow or blood stem-cell transplant to kill cancer cells and bone marrow cells. This is a part of the intensive treatment of some forms of leukaemia.

bone marrow aspiration: A procedure in which a small sample of bone marrow is removed with a wide needle and syringe and sent to a laboratory to check for cancer cells. If a small sample of bone with bone marrow inside it is removed, it is called a bone marrow biopsy.

bone marrow transplantation: A procedure that is used to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation.

bone metastasis: Cancer that has spread to the bone from the original (primary) site.

brachytherapy (also called internal radiotherapy): A type of radiation therapy in which radioactive materials sealed in needles, seeds, catheters, or wires are placed directly into or near a tumour.

brainstem: The part of the brain that is connected to the spinal cord.

BRCA1 and BRCA2: Genes on chromosomes 17 and 13, respectively. A person who is born with changes (mutations) in BRCA1 and BRCA2 genes has a higher risk of developing breast, ovarian, or prostate cancer.

breast reconstruction: Surgery undertaken to rebuild the shape of the breast after removing breast tissue.

breast self-examination: A process in which a woman examines her breasts to check for lumps or other changes.

bronchogenic carcinoma: Cancer that begins in the tissue that lines or covers the airways of the lungs.

C

cachexia: Loss of muscle mass and body weight. Cachexia is seen in patients with late-stage cancer.

cancer: A condition in which there is uncontrolled division of abnormal cells.

cancer antigen 125 (CA-125): A substance that may be found in high amounts in the blood of patients with certain types of cancer, including ovarian cancer.

carcinoembryonic antigen (CEA): A substance that may be found in the blood of people with colon cancer. It is a tumour marker. Levels of CEA help doctors monitor cancer treatment and determine whether the cancer has returned.

carcinogen: Any substance that causes cancer. For example, tobacco smoke contains more than fifty carcinogens. Benzene is a carcinogen that causes leukaemia.

carcinogenesis: A process whereby normal cells start changing into cancer cells.

carcinoma: A cancer that begins in the skin or tissues that line the internal organs of the body, such as squamous cell carcinoma of the skin and adenocarcinoma of the gall bladder.

carcinoma in situ: Abnormal cells (not cancer) that can become cancer cells and spread. They are also said to be in Stage 0 of cancer, such as cervical carcinoma in situ.

carcinoma of unknown primary (CUP): A type of cancer in which cancer cells are found in some parts of the body but the site where the cancer cells originated cannot be determined.

catheter: A flexible tube used to deliver fluids into the body or withdraw fluids from the body.

cavity: A hollow area in the body, such as the abdominal cavity.

cells: The building blocks of the body that make up the tissues and organs of the body. The human body is composed of billions of cells.

cerebellum: The part of the brain between the cerebrum and brainstem.

cerebrospinal fluid: The fluid that flows in and around the hollow spaces of the brain and spinal cord, and between the coverings of the brain called meninges.

cerebrum: The largest part of the brain.

cervix: The lower part of the uterus that forms a canal between the uterus and vagina.

chronic: Persisting over a long period, used of a disease or condition.

circumcision: Removal of part of or the entire foreskin of the penis.

cirrhosis: A chronic liver disease in which the liver cells are replaced by scar tissue.

cognitive behavioural therapy (CBT): A type of psychotherapy that helps patients change their behaviour by changing the way they think and feel about certain things. It is used in the treatment of the mental and emotional problems seen in cancer patients.

colectomy: An operation to remove all or part of the colon.

colitis: Inflammation of the colon.

colon: The longest part of the large intestine; connects the small intestine to the anus. The cancer that arises in the colon and rectum is called colorectal cancer.

colostomy: An operation that connects the colon to the outside of the body through the abdominal wall.

complementary therapy: A type of treatment that is used in addition to conventional or standard treatments. It may include acupuncture, massage therapy, meditation, or reflexology. Complementary and alternative therapies are together called CAM.

conventional medicine or treatment: A system in which doctors, nurses, pharmacists, and other health professionals treat diseases using drugs, radiation, or surgery. Conventional medicine is also called orthodox, or Western, medicine.

counselling: A process in which a counsellor helps a person cope with mental or emotional distress, and understand and solve personal problems.

Crohn’s disease: A condition in which the intestines are inflamed over a long period. It is a type of inflammatory bowel disease that increases the risk of developing colorectal cancer.

cryosurgery: A procedure in which tissue is frozen to destroy abnormal cells. Liquid nitrogen or liquid carbon dioxide is used to freeze the tissues. It is also called cryotherapy or cryosurgical ablation.

cryptorchidism (undescended testicles): A condition in which one or both testicles has not descended from the abdomen into the scrotum. Cryptorchidism may increase the risk of developing testicular cancer.

cyst: A sac in the body. Cysts in the ovary are very common.

cytotoxic drugs: Drugs that kill cells.

D

debulking of tumours: The surgical removal of as much of a tumour as possible. This type of operation is usually done to relieve symptoms of cancer in the late stages of the disease.

diaphragm: The muscular partition that separates the chest from the abdomen.

dilation and curettage: A procedure where some tissues are removed from the lining of uterus or cervix. The cervix is first made larger (dilated) with an instrument called a dilator; then another instrument called a curette is inserted into the uterus to remove the tissue. The removed tissue sample is sent to a laboratory to check for abnormal or cancer cells.

dry orgasm: When a man reaches sexual climax without releasing semen from the penis. This is one of the side effects of prostate surgery.

dyspepsia: An upset stomach.

dysphagia: Difficulty swallowing.

dysplasia: Cells that look abnormal under a microscope but are not cancer.

dysplastic naevi (atypical moles): Naevi (moles) that have a tendency to develop into melanomas.

E

epidermis: The outer layer of the skin.

erectile dysfunction (ED), or impotence: The inability to maintain an erection of the penis that is sufficient for sexual intercourse.

euthanasia (also called mercy killing): The intentional killing of a person to end his or her suffering.

excision: Removal by surgery, such as the removal of melanoma from the skin.

F

faecal incontinence: The inability to hold stool in the rectum.

faecal occult blood test (FOBT): A test to check for blood in the stool that is a screening test for bowel cancer.

faeces: Stool or undigested food.

fallopian tube: A tube that helps eggs pass from the ovary to the uterus.

familial adenomatous polyposis (FAP): An inherited condition in which many polyps form on the inside walls of the colon and rectum. FAP increases the risk of developing colorectal cancers.

familial atypical multiple-mole melanoma syndrome (FAMMM): An inherited condition that increases the risk of developing melanoma and pancreatic cancer.

familial cancer: Cancers that occur in families more often than in the general population, such as breast and colorectal cancer.

fatigue: Extreme tiredness and lack of energy. This is a common symptom among cancer patients.

fertility: The ability to produce children.

fibroadenoma: A benign tumour of the breast.

fibroid: A benign tumour that arises from smooth muscle, such as that of the uterus.

first-degree relatives: The parents, siblings, or children of an individual.

fistula: An abnormal opening or passage between two organs or between an organ and the surface of the body.

follow-up: Monitoring of a person’s health condition over time after treatment.

G

Gardasil: A vaccine to prevent infections by human papillomavirus (HPV) types 16, 18, 6, and 11. It is used to prevent cervical, vulvar, and vaginal cancers caused by these viruses.

gastrectomy: An operation to remove all or part of the stomach.

gastric feeding tube: A tube that is inserted through the nose, down the throat and oesophagus, and into the stomach in order to administer liquid foods, liquids, and drugs. Feeding tubes are often inserted in patients who have mouth, throat, neck, and oesophageal cancers, particularly when the required surgery is extensive or combined with radiotherapy or chemotherapy.

gastrostomy or percutaneous endoscopic gastrostomy (PEG) tube: A tube inserted directly into the stomach through an opening in the skin and abdominal wall. This tube can be used for long-term feeding.

genes: Pieces of DNA that contain the information for making a specific protein that is passed from parent to offspring.

genetic: Related to genes.

genetic testing: Analysing DNA to look for a genetic change (mutation) that may indicate an increased risk of developing cancer.

genital: External and internal sex organs, such as the penis in men and the ovaries in women.

genital warts: Raised growths in the genital areas caused by HPV infection.

germ cells: Reproductive cells of the body, including egg cells in women and sperm cells in men. Tumours that arise from germ cells are called germ cell tumours.

glans penis: The head of the penis.

Gleason score: A system of grading prostate cancer tissue based on how it looks under a microscope. Gleason scores range from two to ten and indicate how likely it is that a tumour will spread. A low Gleason score means the cancer tissue is less likely to spread, while a high Gleason score means the cancer tissue is more likely to spread.

H

haematuria: Blood in the urine.

haemoptysis: Coughing out blood from the respiratory tract.

haemorrhoid: A swollen blood vessel, usually seen in the anus or rectum.

hepatoblastoma: A type of liver cancer most common among infants and children.

hepatocellular carcinoma: The most common type of liver cancer.

hereditary: Transmitted from parent to child by information contained in the genes.

hereditary non-polyposis colon cancer (HNPCC): An inherited disorder in which affected individuals have a higher-than-normal chance of developing colorectal cancer.

high-intensity focused ultrasound (HIFU): A procedure in which high-energy sound waves are aimed directly at the cancer or abnormal cells. These waves create heat and kill abnormal or cancer cells. Some types of prostate cancers are treated with HIFU.

histology: The study of cells and tissues under a microscope.

history: The signs and symptoms a patient may have for a particular disease.

HIV: Human immunodeficiency virus that causes acquired immune deficiency syndrome (AIDS).

hormonal therapy: Treatment of cancer using synthetic hormones or other drugs. It is used to treat breast and prostate cancer.

hospice care: A type of care provided to cancer patients (or their families) who are at the end of their lives. The care can be provided in the patient’s home, a nursing home, or a hospital.

hot nodules: In order to diagnose thyroid cancer, a radioactive material is given to the patient to swallow. Normal thyroid tissue picks up more of the radioactive substance; thus this tissue is called hot nodules, which are unlikely to be cancer. Thyroid cancer cells do not pick up the radioactive substance as quickly as normal thyroid tissue; thus they are called cold nodules. Cold nodules can be cancer.

human herpes virus 8 (HHV8), or Kaposi’s sarcoma–associated herpes virus (KSHV): A type of virus that can cause Kaposi’s sarcoma.

hysterectomy: An operation in which the uterus and/or cervix is removed. When both the uterus and cervix are removed, this is a total hysterectomy. When only the uterus is removed, this is a partial hysterectomy.

I

immunotherapy: A treatment that boosts the body’s immune system to fight cancer, such as immunotherapy of bladder cancer with the BCG vaccine.

implant: A substance or object that is put in the body as prosthesis, such as a breast implant after the removal of a breast during cancer treatment.

incidence of cancer: The number of new cases of a cancer diagnosed over a given time period.

incision: A cut made in the body by a surgeon to perform surgery.

incontinence: The inability to control urine from the bladder or stool from the rectum. These are called urinary incontinence and faecal incontinence, respectively.

induction therapy: The initial treatment given to reduce a cancer, such as induction therapy for acute myeloid leukaemia.

inflammatory bowel diseases: Refers to ulcerative colitis and Crohn’s disease.

in situ: Meaning in its original place. Carcinoma in situ means the abnormal cells are found only in the place where they first formed and have not spread nearby.

intensity-modulated radiation therapy: A type of radiation therapy that uses computer-generated images to show the size and shape of a tumour and to direct thin beams of radiation at the tumour from different angles. This type of radiation therapy reduces the damage to healthy tissue near the tumour.

internal examination, or pelvic examination: The examination of internal organs, such as the vagina, uterus, or rectum, by a health professional.

intrathecal chemotherapy: Treatment in which anticancer drugs are injected into the fluid-filled space between the tissue that covers the brain and spinal cord.

intravenous chemotherapy: Treatment in which anticancer drugs are injected into a vein through a cannula.

L

laser surgery: A surgical procedure that uses intense narrow beams of light to cut and destroy cancer tissue.

leukaemia: A cancer that starts in blood-forming tissues, such as the bone marrow.

libido: Sexual desire. A low libido is a low sexual desire.

lumbar puncture or spinal tap: A procedure in which a needle is inserted in the lower part of the spinal column to collect cerebrospinal fluid or administer medications.

lymph vessels: Tubes that carry lymphatic fluid and white blood cells through the lymphatic system.

lymphoedema: A condition in which extra lymph fluid builds up in tissues and causes swelling. This can be seen in the arm after breast operations.

M

malignant: Cancerous. Malignancy is the term used for a group of malignant cells that invade and destroy tissues.

mass: A lump. It can be a benign mass or malignant mass.

mastectomy: The removal of the breast.

melanoma: The cancer that begins in melanocytes. A common site is the skin, but melanoma can also occur in the eyes.

meninges: The three layers of tissue that cover the brain and spinal cord.

menopause: The period during a woman’s lifecycle when menstruation stops and the ovaries cease producing hormones.

metastasis: The spread of cancer from one part of the body to another. The cancer that is formed by cells that have spread from the original site is called metastatic cancer or a metastatic tumour.

mucous membrane: The moist inner lining of some organs or body cavities, such as the mouth, vagina, and stomach. Mucous membranes contain glands that produce mucous, which makes the lining moist.

multidisciplinary team: A team that includes a number of doctors and other healthcare professionals who are involved in providing treatment to a cancer patient. The team members may include physicians, oncologists, surgeons, dieticians, psychologists, and other experts in healthcare.

mutate: To change. Mutation refers to changes in the DNA of a cell.

N

nausea: A feeling of sickness or the urge to vomit. Nausea is a very common side effect of radiotherapy and chemotherapy.

neoplasia: An abnormal and uncontrolled cell growth.

neoplasm: An abnormal mass of tissue. Neoplasms can be benign or malignant (cancerous).

nerve block: A procedure in which a drug is injected directly into or around a nerve to block pain.

neuropathic pain: Pain due to nerve damage. Some chemotherapy drugs cause neuropathic pain.

nodule: A growth, lump, or mass that can be benign or malignant.

O

oncogene: A changed or mutated gene that may cause the growth of cancer cells.

oncology: The study of cancer.

opiates and opioids: Drugs used to treat cancer pain, such as codeine and morphine.

opportunistic infections: Infections caused by organisms that do not normally cause a disease one is already suffering from. Opportunistic infections occur among people who have weakened immune systems or are being treated with chemotherapy.

oral: Relating to the mouth. Some chemotherapy drugs can be administered orally.

orchidectomy: Surgery to remove one or both of the testicles.

P

palliative therapy or treatment: Treatment given to relieve the symptoms and reduce the suffering of a cancer patient. Palliative care aims to improve the quality of life of patients.

Papanicolaou (Pap) test: A procedure in which cells are scraped from the cervix and examined under a microscope. This test is done to detect cancer or any changes in the cervix that may lead to cancer.

partial: Not whole. For example, a partial gastrectomy involves part of the stomach being removed.

pelvis: The lower part of the body between the hipbones.

penectomy: Surgery to remove part of or the entire